Heroin-Related Deaths Up Sharply In Connecticut

Increase Mirrors National Trend; Attorney General Vows To Fight 'Urgent Public Health Crisis'

SOURCE: Office of the Chief Medical Examiner. Data are preliminary; further investigation could identify other causes of death in some cases.

March 10, 2014|By DAVID OWENS, dowens@courant.com, The Hartford Courant

Accidental heroin deaths in Connecticut last year were up 48 percent from 2012, mirroring a trend across New England and the nation that the U.S. Attorney General Eric Holder on Monday called an "urgent public health crisis."

In Connecticut, 257 people died from heroin-related overdoses in 2013, up from 174 in 2012, according to data released by Chief Medical Examiner James R. Gill. In Hartford County, heroin overdose deaths increased 55 percent over the same period, to 82 in 2013 from 53 in 2012.

Heroin-related deaths and accidental overdoses have been on the rise throughout the Northeast. Authorities in Pennsylvania, Rhode Island, Massachusetts, Maine and Vermont have all reported significant increases in overdose deaths.

Vermont Gov. Peter Shumlin devoted most of his state of the state address in January to Vermont's heroin problem, which he called an "immediate health crisis." Fatal overdoses there nearly doubled from 2012 to 2013.

Heroin deaths nearly doubled from 2012 to 2013 in Hartford as well, and last month city police took the unusual step of warning addicts about an especially nasty batch of heroin contaminated with the synthetic opiate fentanyl. Heroin overdoses killed 31 people in Hartford in 2013, compared to 16 the previous year.

Accidental deaths from all drugs — including heroin, cocaine, morphine, codeine and mixes of drugs — increased 38 percent in Connecticut to 490 in 2013 from 355 in 2012, according to the data.

The steep death toll has continued into 2014, police said, although some overdose data are not available.

East Windsor has had four confirmed fatal heroin overdoses since Nov. 1, police said, and heroin is suspected in the deaths of three other people there as well. Fourteen-year-old East Windsor High School student Megan Koscinski died on Feb. 16.

"I would say 2014 is certainly going to be consistent with the rise in 2013," Hartford Deputy Police Chief Brian Foley said. Hartford narcotics detectives are "attacking it head-on," Foley said. "It is getting the majority of our narcotics attention right now. We're working with outside municipalities as necessary."

The especially dangerous heroin-fentanyl mix has attracted much attention, but the larger problem is the dramatic increase in the number of people using heroin, said Dr. Danyal Ibrahim, chief of toxicology at St. Francis Hospital and Medical Center in Hartford.

Efforts to curtail abuse of prescription opiates such as oxycodone have pushed addicts to heroin, he said.

Abuse of prescription opiates such as OxyContin began to emerge in the 1990s and exploded into a serious problem in the early 2000s. To curb abuse, the drug manufacturers reformulated OxyContin to make it more difficult to abuse, and the government aggressively prosecuted doctors who improperly prescribed the drugs. The reformulation made it more difficult for addicts to crush the drug into a powder they could then snort or inject.

Some addicts found ways to overcome the new formula. Others moved onto more readily available and less expensive heroin, Ibrahim said.

"If I am an addict on Vicodin or Percocet now experiencing withdrawal, an alternative is heroin because it works on the same receptors [in the brain]," Ibrahim said.

Theodore J. Cicero, a professor of neuropharmacology in psychiatry at Washington University in St. Louis, and a team of researchers noted the migration of prescription drug abusers to heroin in 2012 as a result of the reformulation of prescription narcotics.

They were so alarmed at what they found that they alerted the medical community in a letter to the New England Journal of Medicine. "It's a very new development [in] the last two to three years," Cicero said of the dramatic increase in heroin use by people who were abusing prescription drugs. "We're beginning to see all across the country an increase in overdose deaths."

Heroin use, which used to be confined mostly to cities and minority communities, has moved forcefully into the suburbs and rural areas. And the driver, Cicero said his research shows, is prescription drug abusers no longer able to get their hands on oxycodone who have moved on to heroin. "That's a very ominous development."

"Dealers have transitioned from shady people in the inner city to teenagers you go to school with, you work with," he said. There's also been a troubling change in attitude about heroin, he said.

"The whole social stigma with heroin has dissipated over time," Cicero said. "We see kids skipping right over prescription opiates and jumping right into heroin."

Although injecting heroin still carries a stigma, dealers introduce prescription drug addicts and others to heroin by telling them they can snort it or smoke it. Heroin is so addictive, though, that it's only a matter of time until users inject it.

The life of a heroin addict is already dangerous, especially for one who abuses heroin intravenously. Infections and diseases from sharing needles are a constant threat, Cicero said.